Provider Demographics
NPI:1851639116
Name:WILLIAMSVILLE FAMILY CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:WILLIAMSVILLE FAMILY CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:PAWELEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-276-8931
Mailing Address - Street 1:154 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2345
Mailing Address - Country:US
Mailing Address - Phone:716-276-8931
Mailing Address - Fax:716-204-0786
Practice Address - Street 1:154 PLAZA DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-2345
Practice Address - Country:US
Practice Address - Phone:716-276-8931
Practice Address - Fax:716-204-0786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010177111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCC9015Medicare Oscar/Certification
NYU87037Medicare UPIN